A vocabulary of dis-ease: argumentation, hot zones, and the intertextuality of bioterrorism.

• Author: Ayotte, Kevin J.
• Position: Report

"[A]s nothing exists outside the text, there is never a whole of the text."

--Roland Barthes

On February 19, 2010, the FBI closed its investigation into the 2001 anthrax mail attacks, concluding on the basis of an array of circumstantial evidence that the late Dr. Bruce Ivins of the United States Army Medical Research Institute of Infectious Diseases (USAMRIID) at Fort Detrick, Maryland, had produced and mailed the anthrax spores. Ivins had committed suicide in July 2008 allegedly as a result of the pressure of the FBI's investigation, but neither Ivins's death nor the FBI's decision that it could adequately prove its case in fact resulted in an end to the public deliberation about the anthrax attacks. Representative Rush Holt (D-NJ), for example, immediately called for a congressional review of the FBI's work and decision to close the inquiry (Shane, 2010). More than merely a final step in legal or administrative protocol, the FBI's closing of the case despite ongoing public argumentation reveals the wish to say completely, to make present in its epistemological totality, the truth of the U.S. experience of bioterrorism. Such a truth would be more than simply accurate data gathered through forensic science; it would be only that data with the additional stipulation that there is nothing more to be said, no more text to interpret, even as the U.S. public continues to negotiate what bioterrorism means for society. An actual trial would have demonstrated the fundamental impossibility of truly closing the case by making plain that the FBI's conclusion was not settled truth but an argument. Whatever the final verdict, Ivins's guilt or innocence would have been determined by the effect of a multitude of persuasive appeals toward the jury rather than the ontological fact of whether or not he produced and mailed the anthrax spores.

The assumption of a phenomenal world knowable as a kind of closed truth, however, is an epistemological feature endemic to the vast majority of U.S. risk communication about the threat posed by biological weapons and bioterrorism. Analyses of perceived failures of bioterrorism risk communication cite the public's undesirable behaviors or lack of accurate medical knowledge as an inability on the part of the audience to respond appropriately to the objective facts of disease. Thus, following the 2001 anthrax mail attacks, Marshall, Begier, Griffith, Adams, and Hadler (2005) cite the fact that tens of thousands of people took ciprofloxacin prophylactically, given the occurrence of five deaths out of a total 22 infections, to conclude that "[t]he anthrax attacks caused a national reaction out of proportion to the event itself" (p. 247). Neither the uncertainty about the extent of exposure in the midst of the anthrax mailings nor an abundance of public health caution adequately explains the response. While public health officials erred on the side of caution in cases with any reasonable possibility of exposure and provided the antibiotic for prophylactic use, orders through private insurers skyrocketed, with widespread concerns about hoarding of the publicized drug-of-choice against anthrax (Petersen & Pear, 2001). Many factors contributing to the alarm surrounding the anthrax attacks have been studied, and Vanderford (2003) stated that "[t]raining in the new field of risk communication has been offered as the best solution to communication problems in future emergencies" (p. 11) handled by the Centers for Disease Control and Prevention (CDC). The Crisis and Emergency Risk Communication textbook (Reynolds, 2002) utilized for this training relies, like several other studies on bioterrorism risks conducted for the CDC, upon a general epistemology that contrasts a world of accurate information to exaggerations or public misunderstanding of risk and crisis communication (see Ayotte, Bernard, & O'Hair, 2009, pp. 617-18).

This epistemological assumption can be seen across scholarship adopting what is essentially a deficit model of public health knowledge. Blendon et al. (2003) report that "survey results suggest the need for public education about smallpox, since many Americans have beliefs about the disease that are incorrect according to scientific views" (p. 431). Marshall et al. (2005) therefore advocate public education with the objective of "an increase in knowledge of smallpox mortality, transmission, contagiousness, and vaccine risk [which] would result in less anxiety and more rational personal decisions and public health response demands by the public" (p. 252). Public health officials often identify the simple lack of information about the relatively novel threat of bioterrorism, outside most people's rudimentary knowledge of disease pathology and transmission, as a cause of public misunderstanding. Other commentators blame news media and politicians' "gross exaggeration" (Leitenberg, 2005, p. 45) of the threat of bioterrorism for behavior out of line with critics' assessment of the threat (see also Cole, 1999; Tucker & Sands, 1999).

The positivist epistemological framework of public health officials-framing knowledge as either present or lacking, accurate or inaccurate-misunderstands the problem. Audiences interpreted public health advocacy surrounding the 2001 anthrax mailings, like all discourse advancing arguments about the nature of and response to bioterrorism threats, within an already established context of cultural knowledge about killer viruses. This article broadens understanding of how people in the United States have come to know bioterrorism by examining the manner in which post-Cold War public discourse about biological terrorism has been inflected by the intertextuality of U.S. encounters with so-called "emerging" viruses such as Ebola. More specifically, I argue that the rhetorical legacy of Richard Preston's (1994) nonfiction book, The Hot Zone, plays a significant role in shaping the premises of public arguments about biological threats. Public health officials need to understand all bioterrorism risk communication as fundamentally rhetorical, a complex process of arguing about the nature, probability, and significance of hazards. This risk communication is part of, and its meaning is shaped by, a wider discourse about viral outbreaks that achieved cultural prominence shortly after the end of the Cold War. Critical attention to arguments in contemporary biosecurity discourse must therefore account for data and warrants that derive their content from intertextual references to popular culture outside of the medical facts offered by any particular instance of risk communication.

The first section of this article establishes a theoretical framework for exploring the role of latent cultural knowledge in situating new information about bioterrorism within an established array of meanings available to public audiences. The second section identifies the commercial news media's reliance on the intertextuality of The Hot Zone for interpreting the 2001 anthrax mailings and subsequent fears of bioterrorism. The third section of the essay traces the establishment of The Hot Zone, and its gruesome account of the Ebola virus, as a key coordinate of what would become the cultural map for bioterrorism in post-Cold War U.S. public argument. The final section of the article considers the impact of this cultural map, with its vocabulary of dis-ease, on public argumentation about bioterrorism.

NEWS, CULTURE, AND THE MEANING OF BIOTERRORISM

Although public health officials are the most trusted source of information about bioterrorism, the primary sources of information actually utilized are local television and radio followed by cable and network television news channels (Pollard, 2003), requiring a careful analysis of the ways in which media quite literally produce information on this topic. Following what it perceived to be certain missteps in public health risk communication during the anthrax event of 2001, the CDC's Office of Communication seemed to recognize some of the complexity of mediated risk communication. For instance, Vanderford (2003) emphasized the importance of attention to contextual variables such as "audience beliefs, earlier messages audiences have heard about a subject, and competing messages" (p. 12) that can affect audience response to messages during public health emergencies. As I argue below, the absence of explicit attention to the texts of popular culture that comprise a great deal of the message competition hampers the ability of risk communicators to appreciate fully the range of messages responsible for constructing public knowledge on this issue. The positivist tendency noted above in most risk communication, encouraging a narrow focus on media exaggeration of biological threats as the primary cause of public misinformation, may thus be one of the obstacles to promoting a more critically aware knowledge of bioterrorism.

A discussion among journalists and security experts is illustrative of both the incentive for journalists to dramatize potential dangers and the difficulty faced by journalists and responsible media corporations enmeshed in a market-driven news environment that depends on drawing audiences through dramatic spectacle. Jonathan Tucker, director of the chemical and biological weapons nonproliferation program at the Monterey Institute of International Studies, recognized that rhetorical restraint by expert sources regarding suspected bioterrorism is complicated by reporters' desire to tell a coherent story: "we can limit the range of hypotheses to those consistent with the facts, but until we have more facts, it's perfectly natural for experts or the news media to speculate" (as cited in Connolly, Dentzer, Keane, & Tucker, 2003, p. 132). In fact, the filling-in of unknown premises often tends to amplify, rather than diminish, the portrayed magnitude of a novel event such as the anthrax mail case, as demonstrated by Susan Dentzer...